Enrollment Specialist

2d4a5356-e068-4295-b443-4d720d34acb5 • Whittier, CA

8h • $0 - $30

About The Position

The Enrollment Specialist assists patients with health insurance enrollment, Medi-Cal renewal and retention, CalFresh applications, and information about insurance plans accepted at the clinic. The role supports continuous health coverage through enrollment assistance, proactive outreach, renewal support, and follow-up. The specialist guides patients through enrollment and renewal requirements, works assigned termination and renewal lists, contacts patients at risk of losing Medi-Cal coverage, obtains missing application information and supporting documentation, and helps address barriers to continued coverage. The position also maintains accurate patient information in the Electronic Health Record (EHR) and designated tracking systems to help reduce coverage lapses and preserve access to healthcare services. The specialist must have the required qualifications or be willing to complete the necessary training and certification to assist with health insurance enrollment and retention.

The role provides education and practical assistance with Covered California, Medi-Cal, CalFresh, General Relief, health plan selections, transportation benefits, interpretation and translation services, and relevant community resources. It includes verifying eligibility, coordinating with patients and appropriate enrollment personnel or agencies, documenting activities, preparing reports, and meeting departmental outreach and productivity goals. The position requires effective communication, organization, follow-up, confidentiality, and the ability to manage assigned cases independently and collaboratively.

Work schedule: Monday through Friday, 8:00 a.m. to 4:30 p.m.

Requirements

• High school diploma or equivalent.
• CAA (Certified Application Assistor) certification is required; if not current at hire, it must be obtained within six months of hire.
• Ability to communicate effectively verbally and in writing with patients, the public, medical staff, and physicians.
• Must hold or be willing to obtain the required certification to assist patients with health insurance enrollment within the designated timeframe.
• Knowledge of EHR systems and accurate patient data entry.
• Knowledge of health insurance programs, coverage options, and enrollment processes, including Covered California and Medi-Cal, or ability to learn applicable requirements.
• Excellent organizational skills and attention to detail.
• Ability to work independently and demonstrate effective time management, prioritization, and follow-up skills.
• Ability to maintain patient confidentiality and handle sensitive personal information appropriately, including compliance with HIPAA and applicable organizational privacy and security policies.
• Ability to explain information clearly, assist patients with application documentation, and connect them with appropriate community resources.
• Strong telephone communication and patient service skills, including ability to explain renewal requirements and help patients navigate renewals.
• Ability to conduct proactive outreach, manage assigned termination and renewal lists, prioritize time-sensitive cases, and complete timely follow-up.
• Strong organizational and case management skills, including ability to manage multiple cases while meeting productivity expectations.
• Basic computer skills, including data entry, electronic recordkeeping, and use of tracking systems.
• Ability to document patient interactions, maintain accurate records, and prepare routine productivity reports.
• Ability to identify barriers to Medi-Cal retention and refer patients to an appropriate agency, department, or resource when additional assistance is needed.
• Ability to collaborate with the Enrollment team, Enrollment Manager, and other departments while independently managing assigned responsibilities.

Nice To Haves

• One year of experience in a medical office or related healthcare or patient enrollment setting.
• CPR certification.
• Experience in healthcare enrollment, Medi-Cal eligibility and renewals, patient outreach, customer service, or a related field.
• Experience assisting patients with public health insurance programs or navigating government benefits systems.
• Experience with telephone outreach, case follow-up, data entry, or maintaining tracking lists.
• Bilingual Spanish-speaking skills, including English/Spanish.
• Familiarity with CalFresh and General Relief (GR) programs and their application requirements.
• Familiarity with the Los Angeles County Department of Public Social Services (DPSS), BenefitsCal, and Medi-Cal eligibility verification systems.
• Knowledge of Medi-Cal coverage, renewal processes, eligibility requirements, and common reasons for coverage termination.

Responsibilities

• Provide patients with information about managed care and available health insurance coverage options and health plans.
• Screen patients for enrollment eligibility and schedule initial enrollment appointments.
• Enroll patients in Covered California health insurance plans.
• Review assigned Medi-Cal termination and renewal lists, identify patients at risk of losing coverage, and prioritize outreach based on deadlines or potential termination.
• Conduct outbound telephone outreach to patients whose Medi-Cal coverage is nearing termination or has been discontinued; explain renewal requirements and deadlines.
• Contact cash-paying patients and disenrolled members to assess eligibility, identify reasons for disenrollment, and assist with re-enrollment when appropriate.
• Assist with CalFresh applications and renewals, including required Semi-Annual Reports (SAR 7).
• Help patients complete and submit Health Care Options and Medi-Cal health plan selection forms.
• Contact health plans to request Primary Care Physician (PCP) changes on behalf of patients.
• Help patients access health-plan transportation benefits and interpretation or translation services as needed.
• Conduct outreach to increase patient enrollment and expand the clinic's patient roster.
• Connect patients with community resources, including housing and employment assistance, based on their needs.
• Provide information and application assistance to eligible patients seeking Los Angeles County General Relief (GR), including help with requirements and supporting documentation as appropriate.
• Help patients understand Medi-Cal renewal notices, eligibility requirements, reporting obligations, deadlines, and documentation by telephone.
• Guide patients through BenefitsCal to review renewal information and submit required documentation as appropriate.
• Assist patients in contacting the Los Angeles County Department of Public Social Services (DPSS) about pending renewals, missing documentation, and eligibility questions.
• Educate patients about keeping their contact information current with DPSS.
• Identify patients needing help maintaining or restoring Medi-Cal coverage and explain available reinstatement or reapplication options when coverage has ended.
• Follow up on outstanding renewal requirements, missing documentation, and unresolved coverage issues until resolved or appropriately referred.
• Coordinate with patients and enrollment personnel to facilitate continued coverage and reduce preventable gaps in Medi-Cal enrollment.
• Verify Medi-Cal eligibility and coverage status using authorized systems and established procedures.
• Review eligibility information, renewal dates, and termination notices to identify potential coverage interruptions and determine follow-up actions.
• Identify cases requiring additional documentation, eligibility clarification, or intervention from DPSS or another appropriate agency; refer cases when further assistance is needed beyond the position's scope.
• Follow established procedures for communicating eligibility information and coordinating referrals.
• Submit weekly reports documenting completed enrollments.
• Accurately and promptly document outreach attempts, telephone communications, enrollment and renewal assistance, referrals, and follow-up activities.
• Maintain accurate, current records in the retention tracking system and applicable EHR systems; update records with patient outcomes and case status.
• Submit daily productivity reports to the Certified Enrollment Manager in accordance with departmental procedures.
• Monitor assigned retention cases and identify patients needing additional outreach, documentation, or assistance.
• Meet outreach, documentation, and productivity goals established by the Certified Enrollment Manager.
• Communicate unresolved cases and enrollment or retention barriers to the appropriate supervisor or department in a timely manner.
• Contribute to reducing preventable Medi-Cal coverage losses and maintaining continuity of patient access to healthcare services.
• Perform other related duties as assigned.
• Maintain patient, employee, and Foundation confidentiality and share protected health information only as permitted and necessary.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED